TY - JOUR
T1 - Prevention of mother-to-child transmission of HIV-1 using highly active antiretroviral therapy in rural Yunnan, China
AU - Zhou, Zengquan
AU - Meyers, Kathrine
AU - Li, Xia
AU - Chen, Qingling
AU - Qian, Haoyu
AU - Lao, Yunfei
AU - Geng, Elvin
AU - Fan, Yishan
AU - Yang, Shaomin
AU - Chiu, Michael
AU - Ho, David D.
PY - 2010/2
Y1 - 2010/2
N2 - Objective: To demonstrate that the use of highly active antiretroviral therapy (HAART) to interrupt transmission of HIV-1 from mother to baby is effective, safe, and feasible in a remote rural region of China. Methods: Between November 2005 and May 2009, we enrolled 279 HIV-1-infected pregnant women to receive HAART to interrupt transmission of HIV-1 to their newborns across 16 counties in Yunnan. All women were started on triple combination therapy and submitted to regular blood draws to monitor CD4 T cells and viral load in their blood plasma. Infants received a single dose of nevirapine at birth and 1 or 4 weeks of zidovudine depending on the length of the mother's regimen. Exclusive formula feeding was recommended, and families were provided with 12-month supply of formula. Mothers and infant pairs were followed for 12-18 months postdelivery. Results: Of 279 enrolled HIV-infected women, 222 (79.6%) were identified and started treatment by 28 weeks of pregnancy. Viral load was undetectable at time of delivery for 62.4% (136 of 218) at delivery, with a mean 1.76 log viral load reduction between enrollment and delivery. Two of 193 babies (1.0%) who have already been tested became infected with HIV-1. Seven of 223 babies have died. By Kaplan-Meier analysis, cumulative one-year survival was 96.3%. Conclusions: The project demonstrated that HAART for all infected pregnant women is effective with a vertical transmission rate of ∼1%. Thus, this project provides a model for China to scale up its efforts to prevent mother-to-child transmission of HIV-1.
AB - Objective: To demonstrate that the use of highly active antiretroviral therapy (HAART) to interrupt transmission of HIV-1 from mother to baby is effective, safe, and feasible in a remote rural region of China. Methods: Between November 2005 and May 2009, we enrolled 279 HIV-1-infected pregnant women to receive HAART to interrupt transmission of HIV-1 to their newborns across 16 counties in Yunnan. All women were started on triple combination therapy and submitted to regular blood draws to monitor CD4 T cells and viral load in their blood plasma. Infants received a single dose of nevirapine at birth and 1 or 4 weeks of zidovudine depending on the length of the mother's regimen. Exclusive formula feeding was recommended, and families were provided with 12-month supply of formula. Mothers and infant pairs were followed for 12-18 months postdelivery. Results: Of 279 enrolled HIV-infected women, 222 (79.6%) were identified and started treatment by 28 weeks of pregnancy. Viral load was undetectable at time of delivery for 62.4% (136 of 218) at delivery, with a mean 1.76 log viral load reduction between enrollment and delivery. Two of 193 babies (1.0%) who have already been tested became infected with HIV-1. Seven of 223 babies have died. By Kaplan-Meier analysis, cumulative one-year survival was 96.3%. Conclusions: The project demonstrated that HAART for all infected pregnant women is effective with a vertical transmission rate of ∼1%. Thus, this project provides a model for China to scale up its efforts to prevent mother-to-child transmission of HIV-1.
KW - HAART
KW - HIV/AIDS
KW - PMTCT
KW - Yunnan
UR - http://www.scopus.com/inward/record.url?scp=75749126981&partnerID=8YFLogxK
U2 - 10.1097/QAI.0b013e3181c7d47b
DO - 10.1097/QAI.0b013e3181c7d47b
M3 - Article
C2 - 20104104
AN - SCOPUS:75749126981
SN - 1525-4135
VL - 53
SP - S15-S22
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - SUPPL. 1
ER -